Reading a novel about a dying person and the people attending the dying, one can not only reflect upon the moral involvement between the literary characters depicted, but also upon the way in which the reader takes the position of a “bystander” in this scene. In two novels, The Death of Ivan Ilyich by Tolstoy and The Big Ward by the Dutch author Jacoba van Velde, this moral involvement can be interpreted as a form of “compassion”. Martha Nussbaum’s concept of “compassionate imagination” offers a perspective on the way in which the reader can be involved in this literary depiction of the dying. However, the Aristotelian criteria that Nussbaum proposes for the rational judgement of compassion and her ambitions that literature can “raise society’s floor” by developing “compassionate imagination” in readers, are difficult to apply to these specific cases. In comparing both novels, it is exactly the differences between them – the historical context and social classes depicted - that bring to light a problematic presupposition in Nussbaum, namely the a-historical universality in the compassionate involvement. A re-interpretation of one of the Aristotelian criteria for compassion leaves room for a “compassionate imagination” not based on a rational judgement but on a sense of shared vulnerability that is precisely evoked by the literary depiction of the dying.
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The aim of this study was to assess the feasibility, acceptability and preliminary effectiveness of Mindfulness-Based Compassionate Living (MBCL) as a follow-up intervention to Mindfulness Based Cognitive Therapy in adults with recurrent depression. We conducted an uncontrolled study in 17 patients with recurrent depression, in two successive groups. The first group contained novices to compassion training (N = 14); in the second group, ten of these participated again, in addition to three new participants (N = 13). The overall group contained 15 females and 2 males, aged between 37 and 71. The MBCL program was qualitatively evaluated using post-intervention focus group interviews in both groups. In addition, self-report questionnaires assessing depressive symptoms, worry and both self-compassion and mindfulness skills were administered before and after MBCL. No patients dropped out of the intervention. Average attendance was 7.52 (SD 0.73) out of eight sessions. Helpful elements were theory on the emotion regulation systems, practicing self-compassion explicitly and embodiment of a compassionate attitude by the teachers. Unhelpful elements were the lack of a clear structure, lack of time to practice compassion for self and the occurrence of the so-called back draft effect. We adapted the program in accordance with the feedback of the participants. Preliminary results showed a reduction in depressive symptoms in the second group, but not in the first group, and an increase in self-compassion in both groups. Worry and overall mindfulness did not change. MBCL appears to be feasible and acceptable for patients suffering from recurrent depressive symptoms who previously participated in MBCT. Selection bias may have been a factor as only experienced and motivated participants were used; this, however, suited our intention to co-create MBCL in close collaboration with knowledgeable users. Examination of the effectiveness of MBCL in a sufficiently powered randomised controlled trial is needed.
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Veel mensen overleden aan COVID-19 met ernstige symptomen en zonder nabijheid van geliefden. Naasten konden patiënten niet bijstaan aan het einde van het leven. Ook zorgverleners in verpleeghuizen en ziekenhuizen ervaren het verlenen van zorg in deze tijd als zwaar. Daarnaast hebben vele tienduizenden mensen in Nederland ernstige verlieservaringen door COVID-19 rond hun baan, dagbesteding, onderneming, sociale contacten of hun zorg. Het lectoraat Zorg rond het Levenseinde (ZRL) van Avans Hogeschool wil samen met het Koning Willem 1 College in Den Bosch een studentenchallenge aansturen om de verhalen rondom het leed geleden door COVID-19 in de stad op te halen en zichtbaar te maken. Maatschappelijke verbinding, herstel en erkenning zijn namelijk onmisbaar, zeker in tijden van groot verlies. In Nederland is er relatief weinig maatschappelijke aandacht, ondersteuning en verbinding geweest voor het verlies geleden door corona. Burgers moeten en kunnen deze verbondenheid zelf creëren, maar dat gaat niet vanzelf. Daar wil deze Challenge bij helpen en wel via het concept 'Compassionate communities' (CCs)Deze bieden een kader voor verbondenheid rond verlies. CCs zijn steden, wijken of buurten waarbinnen de bewoners elkaar steunen bij verlies en kwetsbaarheid. CCs worden gestart door (onderdelen van) het handvest van de CCs te implementeren dat bestaat uit 13 aandachtspunten, waarin o.a. gespecificeerd is dat scholen, werkplekken, gebedshuizen, musea en zorgcentra structureel aandacht hebben voor dood, verlies en zorg. Het doel is om een cultuur te creëren waarin het normaal is om positief met elkaar in contact te komen rond alle vormen van verlies. We vragen studenten om het gedachtengoed van CCs in een ‘Challenge’ te introduceren in Den Bosch rondom het stille leed als gevolg van corona. Het doel van de Challenge is om beeldvorming, communicatie en maatschappelijke samenwerking rond verlies (in brede zin) en andere knelpunten gerelateerd aan COVID-19 te verbeteren.
Training nurses and midwives to treat their patients well There are some specific factors facilitating the modification of the nursing and midwifery bachelor curriculum The development of health literacy and respectful and compassionate care competences among bachelor nursing and midwifery students in Tanzania
